Health Informatics Research Scientist

HealthPlanOne's mission is to help people find the right health insurance at the right price, so they live healthier lives. We are committed to making the shopping process simpler. Our mission has never been more important than it is today.

Our mission has never been more important than it is today.
The Health Informatics Research Scientist is responsible for initiating research topics/hypotheses to innovate and create new computational methods and technologies to address complex challenges in the Medicare and health insurance sector. This role involves conducting independent and collaborative research to develop innovative algorithms, data models, and decision-support systems, and ensure data security and compliance within health insurance operations. This is a 100% Telecommuting Position [may work from anywhere in the continental U.S. other than Alaska, California, Hawaii, Maryland, Michigan, Minnesota, Montana, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, and Wyoming].

Along with the benefits listed below, the salary range for this role is $111,000 - $111,500 commensurate with experience.

Supervisory Responsibilities:

• None

Duties/Responsibilities:

• Conducting research into fundamental and applied computer and information science, focusing on problems relevant to health insurance (e.g. claims analytics, fraud detection, patient outcome modeling, and healthcare process optimization)
• designing, testing and evaluating new algorithms, data structures, and machine learning models for large-scale health data analysis, predictive modeling, and risk assessment.
• Collaborating with interdisciplinary teams including: clinicians, data scientists, policy experts, and IT professionals, to translate research findings into practical solutions for health informatics and insurance administration.
• Organizing and presenting findings/recommendations to management.
• Analyzing and interpreting clinical, claims, and operational data to identify trends, improve service delivery, and support evidence-based decision-making in Medicare and insurance programs.
• Staying current with emerging technologies, privacy and confidentiality regulation data governance and cybersecurity protocols, and best practices in health informatics, artificial intelligence, and insurance analytics.

Required Skills/Abilities:

• U.S. Master's degree in Computer Science, Information Systems, Health Informatics, or a related field.
• Minimum two years' experience in the Medicare space creating new algorithms and machine learning models, including: querying and interpreting large healthcare datasets (e.g. claims, Electronic Health Records, population health data), analyzing trends, and synthesizing insights into actionable reports; drawing from knowledge of Medicare and HIPAA regulations, healthcare data standards and insurance processes to develop data collection methods, analytical processes, and scalable reporting solutions; building complex business visualizations and meaningful key performance indicator dashboards utilizing SQL, Python, Hadoop, and DOMO proficiently; improving data processing efficiency and automating decision making.

Physical Requirements: 

• Must be able to remain in a stationary position (e.g., sitting or standing) for extended periods of time, typically in a cubicle environment (constant noise, fluorescent overhead lighting) 

• Frequent use of a computer, dual monitors, keyboard, mouse, and other standard office equipment such as a telephone, copier, and printer. 

• Must be able to communicate effectively, including exchanging information in person, in writing, by telephone, email or video conferencing. 

• Visual and auditory acuity required to perform job duties effectively, including reading, writing, and interpreting information on screens or in print. 

• Hand dexterity, fine motor skills needed to operate a keyboard and mouse efficiently 

• Reach with hands and arms occasionally 

 Featured Benefits:

• Medical insurance
• Vision insurance
• Dental insurance
• 401(k)

Equal Employment Opportunity (EEO) is a fundamental principle at HealthPlanOne, where employment is based upon personal capabilities and qualifications. HealthPlanOne does not discriminate because of actual or perceived sex, sexual orientation or preference, gender identity, gender, transgender, race, color, religion, national origin, creed, citizenship status, ancestry, age, marital status, pregnancy, childbirth or related medical conditions, medical conditions including genetic characteristics, mental or physical disability, military and veteran status, or any other protected characteristic as established by law. HealthPlanOne requires the necessary drug testing and background checks as part of our pre-employment practices. If you need assistance or an accommodation due to a disability, please contact us to request accommodation at [email protected]